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Praxis Jan 2017
Topics: Athletic Injuries; Diagnosis, Differential; Fractures, Stress; Humans; Ilium; Magnetic Resonance Imaging; Male; Middle Aged; Running; Sacroiliac Joint
PubMed: 28103172
DOI: 10.1024/1661-8157/a002586 -
Surgical and Radiologic Anatomy : SRA Feb 2023To address limited amount of available data and contradictory statements in published works 60 Iliolumbar ligaments extracted from 30 cadavers were examined to describe...
PURPOSE
To address limited amount of available data and contradictory statements in published works 60 Iliolumbar ligaments extracted from 30 cadavers were examined to describe their insertions and morphology.
METHODS
The ligaments were removed during the standard autopsy procedures with a use of an oscillating saw, a chisel and a scalpel. The specimens were photographed before the extraction and measured alongside their anterior margin. Next, they were preserved in formaldehyde, stripped of other soft tissues and then examined, photographed and described.
RESULTS
The mean length of the ligaments was 31.7 mm. 44 specimens were described as single-banded, 13 as double-banded and 3 as other. In 24 cases costal process of L has been fixed to the iliac plate by short ligamentous bands. In 38 cases there was a thick fibrous membrane connected to the ligament. No legitimate insertions on L vertebra were observed.
CONCLUSIONS
Typical iliolumbar ligament consists of a single ligamentous band. Most common variability of the ligament consist of two bands. In approximately 40% of cases the costal process of L can be additionally stabilized to the iliac plate by short, strong ligamentous bands. In 63% of cases a connection between the iliolumbar ligament and a fibrous membrane placed in the frontal plane, superiorly to the ligament, has been observed. There seems to be no convincing proof of existence of the insertion of the iliolumbar ligament on the L vertebra.
Topics: Humans; Lumbar Vertebrae; Ligaments, Articular; Sacroiliac Joint; Ilium; Cadaver
PubMed: 36592184
DOI: 10.1007/s00276-022-03070-y -
European Spine Journal : Official... Feb 2014The rabbit posterolateral intertransverse spine arthrodesis model has been widely used to evaluate spinal biologics. However, to date, the validity and reproducibility... (Review)
Review
PURPOSE
The rabbit posterolateral intertransverse spine arthrodesis model has been widely used to evaluate spinal biologics. However, to date, the validity and reproducibility of performance of iliac crest bone graft, the most common and critical control group, has not been firmly established. We evaluated original research publications that utilized this model, identified which experimental conditions affected fusion rates, and developed an algorithm to predict fusion rates for future study designs.
METHODS
A MEDLINE search was performed for publications through December, 2011 that utilized this model to evaluate fusion rates elicited by iliac crest autograft. All study parameters were recorded, and logistic regression analyses were performed to determine the effects of these variables on fusion rates as determined by either manual palpation or radiographs.
RESULTS
Seventy studies with 959 rabbits in 102 groups met the inclusion criteria. Excluding studies that measured fusion at 4 or fewer weeks or intentionally tried to decrease the fusion rate, the overall fusion rate for autograft was 58.3 ± 16.3 % (mean ± SD) as determined by manual palpation and 66.4 ± 17.8 % by plain radiographs. Regression analysis demonstrated a difference between these outcome measures with a trend towards significance (p = 0.09). Longer time points and larger volumes of autograft resulted in significantly greater reported fusion rates (p < 0.0001 and p < 0.05, respectively). Neither strain, age, weight, nor vertebral level significantly affected fusion rates.
CONCLUSIONS
Although experimental conditions varied across studies, time point evaluation and autograft volume significantly affected fusion rates. Despite some variability demonstrated across certain studies, we demonstrated that when the time point and volume of autograft were controlled for, the iliac crest control group of the rabbit posterolateral spinal arthrodesis model is both reliable and predictably affected by different experimental conditions.
Topics: Animals; Autografts; Bone Transplantation; Disease Models, Animal; Female; Ilium; Male; Rabbits; Reproducibility of Results; Spinal Fusion; Transplantation, Autologous
PubMed: 24166021
DOI: 10.1007/s00586-013-3074-0 -
Journal of Orthopaedic Surgery (Hong... 2022The purpose of this study was to investigate clinical efficacy of posterior tibial artery perforator technique combined with iliac crest autograft in treatment of medial...
Medial Soft tissue and medial malleolus loss-the posterior tibial artery perforator technique combined with iliac crest autograft to Stabilize the ankle and cover Soft tissue defect: A case Series.
PURPOSE
The purpose of this study was to investigate clinical efficacy of posterior tibial artery perforator technique combined with iliac crest autograft in treatment of medial soft tissue and medial malleolus loss.
METHODS
This study involved 11 cases of medial soft tissue and medial malleolus loss from October 2011 to March 2016. Patients were treated with posterior tibial artery perforator technique combined with iliac crest autograft, and given routine treatment, such as rehydration, anti-inflammation, anticoagulation and vasodilation. Ankle function of patients was evaluated according to the American Orthopedic foot and ankle Association (AOFAS) ankle-hind foot scoring system.
RESULTS
All flaps survived without bone exposure, and the appearance of skin flaps was satisfactory. There was one case of arterial crisis, one case of venous crisis, one case of skin edge necrosis and one case of incision infection. Wounds of the above patients were healed. Skin flap was soft and elastic without secondary contracture. The two-point discrimination of skin flap was 5-11 mm. The ankle range of motion was 10-60°. X-Ray showed that grafts healed within 8.6 months. According to AOFAS evaluation, four cases were excellent, four cases were good, and three cases were poor. The excellent and good rate was 72.8%.
CONCLUSIONS
In this study, posterior tibial artery perforator technique combined with iliac crest autograft was used to treat medial soft tissue and medial malleolus loss. The findings demonstrated that this treatment was reliable and efficacious.
Topics: Ankle; Ankle Injuries; Autografts; Humans; Ilium; Perforator Flap; Plastic Surgery Procedures; Skin Transplantation; Soft Tissue Injuries; Tibial Arteries; Treatment Outcome
PubMed: 35982606
DOI: 10.1177/10225536221111588 -
International Journal of Oral and... Feb 2020This study was performed to address the outcomes of patients treated with onlay grafts from the iliac crest to augment the deficient jaw. The results of 173 consecutive...
This study was performed to address the outcomes of patients treated with onlay grafts from the iliac crest to augment the deficient jaw. The results of 173 consecutive patients who underwent bone grafting prior to implant surgery are presented. The grafts were taken from the anterior iliac crest to repair alveolar bone deficiencies that were too large to be corrected using intraoral bone grafts. Three months postoperatively, 869 implants were placed into 190 onlay grafts (167 grafts in the maxilla, 23 in the mandible). The follow-up ranged from 3 months to 23 years post implantation. All patients received a fixed prosthesis. Parameters examined included healing of the donor site and bone grafts, implant survival, peri-implant condition, and donor site morbidity. The overall survival rate for all implants was calculated to be 95%±2.7% according to Kaplan-Meier analysis. The implant survival rate compares favourably with those reported in studies using intraoral and extraoral bone.
Topics: Alveolar Ridge Augmentation; Bone Transplantation; Dental Implantation, Endosseous; Dental Implants; Follow-Up Studies; Humans; Ilium; Mandible; Maxilla; Retrospective Studies
PubMed: 31350123
DOI: 10.1016/j.ijom.2019.07.001 -
BMC Nephrology Apr 2017Patients with an impaired renal function show a high incidence of bone and mineral disturbances. These 'chronic kidney disease - mineral and bone disorders' (CKD-MBD)... (Comparative Study)
Comparative Study
BACKGROUND
Patients with an impaired renal function show a high incidence of bone and mineral disturbances. These 'chronic kidney disease - mineral and bone disorders' (CKD-MBD) range from high turnover osteoporosis to adynamic bone disease. Currently, the histomorphometric analysis of a bone biopsy taken from the iliac crest is viewed as the gold standard for CKD-MBD subtype differentiation. However, the clinical relevance of such a biopsy is questionable since iliac crest fractures are an extremely rare finding. Therefore, we aimed to elucidate if the histomorphometric parameter 'trabecular bone volume (BV/TV)' from the iliac crest is representative for other biopsy locations. We chose two skeletal sites of higher fracture risk for testing, namely, the tibial bone and the lumbar spine, to examine if the current gold standard of bone biopsy is indeed golden.
METHODS
Bone biopsies were taken from 12 embalmed body donors at the iliac crest, the proximal tibia, and the lumbar vertebral body, respectively. Masson-Goldner stained sections of methyl methacrylate embedded biopsies were used for trabecular bone volume calculation. Furthermore, exemplary μ-computed tomography (XtremeCT) scans with subsequent analysis were performed.
RESULTS
Median values of trabecular bone volume were comparable between all body donors with median (interquartile range, IQR) 18.3% (10.9-22.9%) at the iliac crest, 21.5% (9.5-40.1%) at the proximal tibia, and 16.3% (11.4-25.0%) at the lumbar spine. However, single values showed extensive intra-individual variation, which were also confirmed by XtremeCT imaging.
CONCLUSIONS
Distinct intra-individual heterogeneity of trabecular bone volume elucidate why a bone biopsy from one site does not necessarily predict patient relevant endpoints like hip or spine fractures. Physicians interpreting bone biopsy results should know this limitation of the current gold standard for CKD-MBD diagnostic, especially, when systemic therapeutic decisions should be based on it.
Topics: Aged; Biopsy; Cadaver; Female; Humans; Ilium; Lumbar Vertebrae; Male; Middle Aged; Organ Size; Reproducibility of Results; Sensitivity and Specificity; Tibia
PubMed: 28407760
DOI: 10.1186/s12882-017-0550-5 -
Clinical Orthopaedics and Related... Sep 2021
CORR Insights®: Posterior Open-wedge Osteotomy and Glenoid Concavity Reconstruction Using an Implant-free, J-shaped Iliac Crest Bone Graft in Atraumatic Posterior Instability with Pathologic Glenoid Retroversion and Dysplasia: A Preliminary Report.
Topics: Humans; Ilium; Osteotomy; Scapula
PubMed: 33950881
DOI: 10.1097/CORR.0000000000001796 -
The Journal of International Medical... Dec 2019This study was performed to introduce a new method of minimally invasive subtalar arthrodesis (MISA) and assess its clinical effects on traumatic subtalar arthritis... (Clinical Trial)
Clinical Trial
OBJECTIVE
This study was performed to introduce a new method of minimally invasive subtalar arthrodesis (MISA) and assess its clinical effects on traumatic subtalar arthritis (TSA).
METHODS
Fifteen patients (8 male and 7 female; age range, 36–56 years; mean age, 48.67 years) with TSA who underwent MISA were included. All patients were treated using a series instrument. The intraoperative and postoperative indexes were recorded.
RESULTS
Among all patients, the mean operation time was 59.67 ± 16.31 minutes and the mean intraoperative blood loss was 43.33 ± 52.87 mL. Four patients underwent iliac crest bone graft surgery, and one patient developed a complication involving fat liquefaction of the iliac crest wound. The mean bony fusion time among all patients was 3.5 months. According to the American Orthopaedic Foot and Ankle Society standard, an excellent outcome was obtained in eight patients and a good outcome was obtained in seven patients. The operation time and intraoperative blood loss were significantly different between patients who did and did not undergo iliac crest bone graft surgery.
CONCLUSION
MISA is a simple and effective method for the treatment of TSA.
Topics: Adult; Arthritis; Arthrodesis; Female; Humans; Ilium; Male; Middle Aged; Minimally Invasive Surgical Procedures; Subtalar Joint
PubMed: 31179806
DOI: 10.1177/0300060519847814 -
Bone Feb 2021Iliac crest bone biopsy with histomorphometry is the gold standard for diagnosis of abnormalities in bone turnover, yet fractures more frequently occur at the greater...
BACKGROUND
Iliac crest bone biopsy with histomorphometry is the gold standard for diagnosis of abnormalities in bone turnover, yet fractures more frequently occur at the greater trochanter of the hip. Whether bone turnover is similar at these two anatomic sites within individuals is uncertain.
METHODS
We collected bone biopsy samples from the ipsilateral iliac crest and greater trochanter in 9 deceased individuals undergoing autopsies at an academic medical center between March-August 2018. We measured 14 static bone histomorphometry parameters including osteoclast number (N.Oc/T.A), eroded surface (ES/BS), trabecular separation (Tb.Sp), osteoclast surface (Oc.S/BS) and osteoid volume (OV/BV) as markers of bone turnover, mineralization, and volume (TMV), and evaluated the correlation of these markers between the iliac crest and greater trochanter.
RESULTS
Average age at time of death was 58 ± 15 years, 2 were women, and average time from death to autopsy was 2.9 ± 1.8 days. Overall, correlations of the markers of bone turnover across the two sites were poor, ranging from as low as 0 for Tb.Sp (p = 1.0) to as high as 0.583 for Oc.S/BS (p = 0.102).
CONCLUSIONS
Static histomorphometric measures of bone turnover at the iliac crest may not provide reliable information about turnover at other anatomic sites.
Topics: Biopsy; Bone Remodeling; Female; Femur; Humans; Ilium; Male; Osteoclasts
PubMed: 32827849
DOI: 10.1016/j.bone.2020.115604 -
Journal of Orthopaedic Surgery (Hong... 2019The purpose of this article is to investigate the outcomes after anterior cervical discectomy and fusion (ACDF) surgery with stand-alone tricortical iliac crest...
Anterior cervical discectomy and fusion for cervical myelopathy using stand-alone tricortical iliac crest autograft: Predictive factors for neurological and fusion outcomes.
PURPOSE
The purpose of this article is to investigate the outcomes after anterior cervical discectomy and fusion (ACDF) surgery with stand-alone tricortical iliac crest autograft and to determine predictive factors for poor neurological recovery, non-union, graft collapse and loss of C2-C7 sagittal alignment.
METHODS
This was a retrospective study involving patients with cervical myelopathy who underwent ACDF surgery with stand-alone tricortical iliac autograft between 2006 and 2016, with a minimum 2-year postoperative follow-up. Outcomes included the change in Japanese Orthopaedic Association (JOA) scores clinically and timing of fusion, graft height and C2-7 angle measured on lateral radiographs. Any complication such as neurological deterioration, non-union, graft collapse or loss of angle was recorded. Delayed union was considered as radiological union identified only beyond postoperative 6 months. Risk factors including age, smoking, drinking, comorbidities and operative levels were analysed through a multivariate regression for their respective influences on the various outcomes.
RESULTS
Of the 69 patients studied, none of the patients had non-union, while 33 (47.1%) achieved fusion in 6 months. The most common complications were anterior protrusion of graft (5.8%) and hoarseness (2.9%). The 1-year mean change in JOA score was 3.9 ± 2.7. The C2-7 angle gradually became more kyphotic, despite an initial lordosis correction intraoperatively. The graft height also gradually collapsed during subsequent follow-ups. Multivariate regression model suggested that diabetics (cumulative odds ratio 7.4) and drinkers (cumulative odds ratio 8.6) were associated with delayed union.
CONCLUSION
ACDF using tricortical iliac crest autograft has satisfactory outcomes with low occurrence of complications. Diabetics and drinkers were predictors of delayed union.
Topics: Adult; Aged; Bone Transplantation; Cervical Vertebrae; Diskectomy; Female; Humans; Ilium; Male; Middle Aged; Radiography; Retrospective Studies; Spinal Cord Diseases; Spinal Fusion; Transplantation, Autologous; Treatment Outcome
PubMed: 31451033
DOI: 10.1177/2309499019869166